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Query: UMLS:C0033377 (prolapse)
11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A review of the new concepts of the anatomy of the anal sphincter mechanism and the physiology of defecation is presented. The external sphincter is a triple-loop system; each loop can function as a separate sphincter through voluntary inhibition action and mechanical compression. Stress defecation resulting from internal sphincter damage is described. A new technique for repair of rectal incontinence is presented, which depends on inducing continence not only by mechanical compression, but also by voluntary inhibition. The mechanism of defecation and rectal continence is described and four types of incontinence presented. Also, the mechanism of both the levator dysfunction syndrome and prolapse is demonstrated and a technique of repair is presented. The study defines two types of rectal anomalies; suprahiatal and infrahiatal. The role of the embryonic anorectal sinus, anorectal band, and epithelial debris in the genesis of perirectal suppuration, chronic anal fissure, pruritus ani, and hemorrhoids is described. The communicating veins, identified between the hemorrhoidal and vesical plexuses, offer an explanation for the vague pathologic aspects of recurrent bacteriuria, urethral discharge, cervicitis, and vaginitis, and provide a proper line for their treatment. They also serve to perform a new radiographic technique--anal cystography--and to administer drugs, including chemotherapeutics, in the treatment of pelvic malignancies.
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PMID:A concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. 331 51

Chronic vaginitis is the most common vaginal disorder. Dogs with vaginitis show no signs of systemic illness but often lick at the vulva and have purulent or hemorrhagic vaginal discharges. Vaginitis is most commonly secondary to a noninfectious inciting factor such as congenital vaginal anomalies, clitoral hypertrophy, foreign bodies, trauma to the vaginal mucosa, or vaginal tumors. Inspection of the caudal vagina and vestibule both visually and digitally will often reveal the source of vaginal irritation. Vaginal cytology is used to establish the stage of the estrous cycle as well as distinguish uterine from vaginal sources of discharge. Vaginal cultures are used to establish the predominant offending organism associated with vaginal discharges and may be used as a guide for selection of a therapeutic agent. Vaginitis is best managed by removing the inciting cause and treating the area locally with antiseptic douches. Congenital malformations at the vestibulovaginal or vestibulovulvar junction may prevent normal intromission. Affected bitches may be reluctant to breed naturally because of pain. Such defects are detected best by digital examination. Congenital vaginal defects may be corrected by digital or surgical means. Prolapse of tissue through the lips of the vulva may be caused by clitoral hypertrophy, vaginal hyperplasia, or vaginal tumors. Enlargement of clitoral tissue is the result of endogenous or exogenous sources of androgens. Treatment of this condition includes removal of the androgen source and/or surgical removal of clitoral tissue. Vaginal hyperplasia is detected during proestrus or estrus of young bitches. Hyperplastic tissue will regress during diestrus. Tissue that is excessively traumatized and/or prolapse of the entire vaginal circumference may be removed surgically. Ovariohysterectomy may be used to prevent recurrence. Vaginal tumors are detected most often in older intact bitches. Such tumors are generally of smooth muscle or fibrous tissue origin and benign. Surgical excision of the tumor combined with ovariohysterectomy is usually curative.
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PMID:Vaginal disorders. 348 58

Estrogens, whether natural or synthetic, have a wide range of clinical uses in the human female. In prepubertal females, estrogens are used in treating gonadal dysgenesis, excessive height, and genital infections. During the reproductive years, estrogens are used in managing 1) menstrual disorders (amenorrhea, menorrhagia, dysmenorrhea); 2) infertility (poor cervical mucus and anovulation); 3) pregnancy (abortion, lactation suppression); 4) dermatological disorders (acne vulgaris, hirsutism); 5) combined estrogen/progestogen usage for contraception; and 6) postcoital contraception. During the climacteric/postmenopausal years, estrogens are used in treating menopausal syndrome and breast cancer as well as various genital problems (infection, atropic vaginitis, genital prolapse). In the human male, estrogens are used in treating prostatic carcinoma and sexual problems. Estrogen therapy should be used with caution, and benefits should be weighed against the hazards. Possible side effects and alternative forms of treatment should be considered.
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PMID:Clinical uses of estrogens. 700 4

Abnormalities of the tubular reproductive tract are responsible for decreased fertility in the cow. Typically, these are related to congenital defects such as segmental aplasia or to acquired conditions resulting from infections or trauma caused during breeding or parturition. Infection of the tubular tract may result in vaginitis, cervicitis, metritis, endometritis, pyometra, or salpingitis. Trauma to the tract may result in urovagina, pneumovagina, or prolapse of the vagina or uterus. Retained placenta may result in metritis. Potentially, all of these conditions, unless properly treated, may result in reduced fertility or, in the extreme, sterility. Judicial and properly timed use of antibiotics and ecbolic agents should return the tract to proper function with little or no reduction in fertility. Some conditions, such as prolapse, retained placenta, and pneumovagina, may call for manual or surgical intervention for successful resolution.
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PMID:Abnormalities of the tubular genital organs. 834 74

Treatment of procidentia and vaginal inversion in older women either with pessaries or surgery commonly brings poor results. Women are unable to retain the pessary; they develop vaginitis and vaginal ulcerations; and surgical "correction" fails due to age-induced genital atrophy or previous obstetrical trauma. We performed a retrospective chart review to assess results of our own technique of vaginectomy/hysterectomy and pelvic floor closure for vaginal vault prolapse and procidentia in 26 aged sexually inactive women seen in our practice. The women ranged from 63 to 83 years of age and had borne 0 to 9 children. Where possible, an estrogen-containing medication was introduced into the vagina preoperatively to stimulate thickening of the vaginal mucosa. A standard Heaney or Doderlein vaginal hysterectomy was performed. Operative time averaged 100 minutes, blood loss averaged 278mL, and 5 patients required a blood transfusion. All patients were discharged in good condition after an average stay of 4.67 days, although 9 of the 24 patients had complications. Since body-cavity invasion was minimal, postoperative care was simple, consisting of hydration with intravenous fluids, urine drainage utilizing an indwelling catheter, (while preventing bladder distension), early ambulation, and prophylaxis against infection and thromboembolism.
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PMID:Vaginectomy: Profile of Success in Treating Vaginal Prolapse. 974 87

An interdisciplinary group of researchers developed a conceptual and methodological framework to determine the extent of the problem of reproductive morbidity at the community level in Middle Eastern society and then, in turn, to improve reproductive health conditions in women. It conducted an exploratory study in a family planning clinic in Cairo, Egypt; a medical workshop on clarification of the symptomatology of reproductive morbidity; and a focus group in a village in Giza, Egypt, to ensure that the reproductive morbidity questions of interview questionnaires were appropriate and complete. The group tested the accuracy of the questionnaires in 2 villages in rural Giza (509 women). Field workers went to the women's homes to administer the questionnaire on characteristics of the household during the first visit. During the second visit, they administered the questionnaire on reproductive morbidity, and then the social researcher went with the women to the health center so the women could undergo a gynecological examination. 50% of the women had reproductive tract infections, especially vaginitis. 56% had prolapse, and prevalence increased significantly with age. 63% had anemia, especially 14-19 year olds (76%). Just 24 women (5%) had no reproductive morbidity. About 50% had at least 3 reproductive conditions. The leading problems reported by the women were vaginal discharge (77%), dysmenorrhea (71%), perceived delay in conception (48%), stress incontinence (37%), and pain during intercourse (36%). Feeling of heaviness below, probably indicating prolapse, was the only symptom which increased with age (p = .03). 41% had been pregnant in the last 2 years. 77% delivered at home. Leading conditions during pregnancy were headache (59%) and discharge (45%), and those after delivery were fever and discharge/inflammation (30% for both). The interdisciplinary group proposed 3 mechanisms which are of utmost importance to policy: conducting similar research in other communities, expansion of reproductive health services at the community level, and implementing changes in the education and training programs of health professionals and social scientists.
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PMID:Concepts and measures of reproductive morbidity. 1014 96

The purpose of this study was to survey nursing home women residents for pathologies in the vulvovaginal area. A total of 96 nursing and skilled nursing elderly woman, from four long-term care (LTC) wards entered the study. The average age was 82 (range 66-98). A total of 88% were wheel chair bound, 86% were urinary incontinent and 80% were communication handicapped. A total of 29% of the examined women had vulvovaginal pathologies. Atrophic vaginitis was detected in 14 cases. Candida vaginitis was found in four cases. Six women had uterine prolapse, three had lichen sclerosus and two had cervical polyps. Such a high rate of findings is probably influenced by age related changes, immobilization and incontinence. This study, a first of its kind emphasizes the importance of routine vulvovaginal examination in elderly LTC women.
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PMID:Vulvovaginal examinations in elderly nursing home women residents. 1098 57

A May 1991 workshop on reproductive morbidity attended by 60 participants in Cairo included presentation of results of a study of 509 nonpregnant women aged 20-60 years. The study was conducted by an anthropologist, a biostatistician, 2 obstetrician-gynecologists, and a microbiologist in 2 rural villages of Gizeh. The majority of the women studied had married before age 19, and 80% were illiterate. Despite initial reticence, over 90% of the village women ultimately took part in the study. The team observed the frequency with which the women accepted illness, weakness, and pain as a normal part of life. Physical examinations revealed that 44% had vaginitis, 9% were anemic, 17% had severe anemia, 56% had prolapse, 18% were hypertensive, and 42% were obese. Survey questionnaires revealed that 36% experienced pain during intercourse, 18% had pain in the lower abdomen, 71% had menstrual pain, 15% had pruritus, and 48% feared they were sterile. The team observed that the women were apparently reluctant to use the local health services. The villages had their own health centers staffed by female physicians, but only 1/3 of the women giving birth in the preceding 2 years had sought prenatal care, and 75% chose to deliver at home. Relations between the health workers and the village women must be strengthened if the situation is to be improved. The seminar recommended that the health and social workers make greater efforts to encourage use of the health services by local women.
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PMID:[In Egypt, researchers assess the health of village women]. 1228 55

This pilot study is the first to identify female genital schistosomiasis (FGS) in an Egyptian community setting. The year-long interdisciplinary study, in a small hamlet (ezba), combined clinical assessment with an in-depth study of the social context of reproductive health. Schistosoma haematobium ova were found in 16.7% of women in the study (21/126). Half of the women who agreed to a full gynecological examination (43 of 86) had evidence of reproductive morbidity due to schistosomiasis, either schistosome eggs in the cervix or sandy patches, tissue changes in the reproductive tract. Other reproductive tract morbidities included infections (vaginitis 40%, chronic cervicitis 75%, pelvic inflammation 9%) and prolapse (54%). FGS was associated with dysparunia, abnormal vaginal discharge, vaginal or cervical polyps, contact bleeding, vulval itching and chronic cervicitis. Community members recognized S. haematobium as a health problem, but did not believe that it affected reproductive health. Indeed, they had little awareness of reproductive health and the possible impact of reproductive morbity on women's arduous daily tasks. There was no discussion of any reproductive health issues (except infertility) between women or between spouses. The study identified a number of factors that would affect the identification and treatment of FGS, and reproductive health care in general; (1) the neglect of women's health: (2) misconceptions about reproductive health and family planning; and (3) limited access to, and use of formal health care. The paper ends with a brief discussion of the significance of our findings about FGS, strategies to increase awareness of FGS, and the need for future research.
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PMID:The social context of reproductive health in an Egyptian hamlet: a pilot study to identify female genital schistosomiasis. 1465 48

Afghans comprise one of the largest groups of refugees in the world, with the majority living in Pakistan. The objective of this study was to identify commonly-occurring reproductive tract infections (RTIs), describe knowledge of women about RTIs, and assess physical and behavioural factors contributing to the development of RTIs. Afghan women presenting at Basic Health Units in refugee camps in Haripur, Pakistan, with reproductive health-related complaints, were included in the study (n=634). Data collection included implementation of an interviewer-administered questionnaire, along with a physical examination and laboratory tests. A descriptive analysis was conducted first. Qualitative data were coded and analyzed using predetermined themes. Chi-square test was used for determining the possible relationships between a binary outcome and categorical risk factors. Over three-fourths (76.7%) of those who reported to the health clinics with reproductive complaints had an RTI. Nearly half (49.5%) of these women were diagnosed with some form of vaginitis, and 14.7% were diagnosed with clinical suspicion of pelvic inflammatory disease (PID). Women with cervical prolapse (p = 0.033) or who cleansed after intercourse (p = 0.002) were more likely to have vaginitis. There was a significant difference (p = 0.017) in the prevalence of suspected PID among women who used mud only (11.1%), any water (18.8%), and an old cloth or toilet paper (9.8%) for cleansing after defaecation. Specific physical and behavioural contributors to the high prevalence of RTIs in this population were identified, and recommendations to ameliorate these factors are offered.
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PMID:Reproductive tract disorders among Afghan refugee women attending health clinics in Haripur, Pakistan. 2094 2


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